脂蛋白相关磷脂酶A2水平、微栓子信号与大动脉粥样硬化型急性脑梗死患者短期预后的关系

发布时间：2018-03-18 12:36

本文选题：急性脑梗死　切入点：脂蛋白相关磷脂酶A　出处：《中风与神经疾病杂志》2017年12期 　论文类型：期刊论文

【摘要】：目的研究大动脉粥样硬化型急性脑梗死患者住院时的脂蛋白相关磷脂酶A2水平、微栓子信号对其短期预后的影响。方法募集起病72 h内的大动脉粥样硬化型急性脑梗死患者238例,收集其入院时的临床资料及实验室资料等。根据改良Rankin量表评分将患者分为预后良好组(0~2分)和预后不良组(2分)。将研究对象分为4组:脂蛋白相关磷脂酶A2正常、微栓子信号阴性组(NL/NM);脂蛋白相关磷脂酶A2正常、微栓子信号阳性组(NL/IM);脂蛋白相关磷脂酶A2升高、微栓子信号阴性组(IL/NM);脂蛋白相关磷脂酶A2升高、微栓子信号阳性组(IL/IM)。采用非条件Logistic回归分析脂蛋白相关磷脂酶A2水平、微栓子信号与急性脑梗死短期预后的关系。结果急性脑梗死患者预后不良组入院时的脂蛋白相关磷脂酶A2水平、微栓子信号阳性率均高于预后良好组(均P0.05)。经多因素调整后,与NL/NM相比,NL/IM、IL/NM和IL/IM组发生预后不良的OR值(95%CI)分别为0.719(0.112~4.627)、4.687(1.506~14.588)和14.868(3.373~65.538)。结论急性脑梗死患者入院时脂蛋白相关磷脂酶A2水平是其短期预后不良的独立危险因素,微栓子信号阳性显著放大了高水平脂蛋白相关磷脂酶A2对发生短期预后不良的作用,脂蛋白相关磷脂酶A2/微栓子信号是大动脉粥样硬化型急性脑梗死短期预后不良的预测指标。
[Abstract]:Objective to study the level of lipoprotein associated phospholipase A 2 in patients with atherosclerotic acute cerebral infarction (ACI). Methods 238 patients with atherosclerotic acute cerebral infarction within 72 hours were recruited. According to the modified Rankin scale, the patients were divided into good prognosis group (0 ~ 2 points) and poor prognosis group (2 points). The subjects were divided into 4 groups: lipoprotein associated phospholipase A2 was normal. Negative microemboli signal group (NL / NMN); normal lipoprotein associated phospholipase A 2 (LPA2), positive microembolus signal positive group (NL / IMA); lipoprotein associated phospholipase A 2 (Lipoprotein associated phospholipase A 2) increased, and microemboli signal negative group (P < 0 05); lipoprotein associated phospholipase A 2 (PLA2) increased. The level of lipoprotein associated phospholipase A 2 was analyzed by non conditional Logistic regression analysis. Results the level of lipoprotein associated phospholipase A 2 and the positive rate of microemboli signal in patients with acute cerebral infarction were higher than those in patients with good prognosis (P 0.05). Compared with NL/NM, the OR value of poor prognosis in NL / IMR / NM and IL/IM groups were 0.719 卤0.1124.627 and 14.6871.506 / 14.588, respectively. Conclusion the level of lipoprotein associated phospholipase A2 in patients with acute cerebral infarction at admission is an independent risk factor for poor short-term prognosis. Microemboli signal positive amplified the effect of high level lipoprotein associated phospholipase A 2 on the short term poor prognosis. Lipoprotein associated phospholipase A 2 / microemboli signal was a predictor of poor short-term prognosis of acute cerebral infarction in atherosclerotic type.
【作者单位】：江苏省南通市第一人民医院神经内科;
【分类号】：R743.3

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